Pattern Of Dilatation Research Articles

Detecting simulated versus bona fide traumatic brain injury using pupillometry.

Objective: Pupil dilation patterns are outside of conscious control and provide information regarding neuropsychological processes related to deception, cognitive effort, and familiarity. This study examined the incremental utility of pupillometry on the Test of Memory Malingering (TOMM) in classifying individuals with verified traumatic brain injury (TBI), individuals simulating TBI, and healthy comparisons. Method: Participants were 177 adults across three groups: verified TBI (n = 53), feigned cognitive impairment due to TBI (SIM, n = 52), and heathy comparisons (HC, n = 72). Results: Logistic regression and ROC curve analyses identified several pupil indices that discriminated the groups. Pupillometry discriminated best for the comparison of greatest clinical interest, verified TBI versus simulators, adding information beyond traditional accuracy scores. Simulators showed evidence of greater cognitive load than both groups instructed to perform at their best ability (HC and TBI). Additionally, the typically robust phenomenon of dilating to familiar stimuli was relatively diminished among TBI simulators compared to TBI and HC. This finding may reflect competing, interfering effects of cognitive effort that are frequently observed in pupillary reactivity during deception. However, the familiarity effect appeared on nearly half the trials for SIM participants. Among those trials evidencing the familiarity response, selection of the unfamiliar stimulus (i.e., dilation-response inconsistency) was associated with a sizeable increase in likelihood of being a simulator. Conclusions: Taken together, these findings provide strong support for multimethod assessment: adding unique performance assessments such as biometrics to standard accuracy scores. Continued study of pupillometry will enhance the identification of simulators who are not detected by traditional performance validity test scoring metrics. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Enhancing models of social and strategic decision making with process tracing and neural data.

Every decision we take is accompanied by a characteristic pattern of response delay, gaze position, pupil dilation, and neural activity. Nevertheless, many models of social decision making neglect the corresponding process tracing data and focus exclusively on the final choice outcome. Here, we argue that this is a mistake, as the use of process data can help to build better models of human behavior, create better experiments, and improve policy interventions. Specifically, such data allow us to unlock the "black box" of the decision process and evaluate the mechanisms underlying our social choices. Using these data, we can directly validate latent model variables, arbitrate between competing personal motives, and capture information processing strategies. These benefits are especially valuable in social science, where models must predict multi-faceted decisions that are taken in varying contexts and are based on many different types of information. This article is categorized under: Economics > Interactive Decision-Making Neuroscience > Cognition Psychology > Reasoning and Decision Making.

Synchronization of Pupil Dilations Correlates With Team Performance in a Simulated Laparoscopic Team Coordination Task.

Modern surgery crucially relies on teamwork between surgeons and assistants. The science of teamwork has been and is being studied extensively although the use of specific objective methodologies such as shared pupil dilations has not been studied as sufficiently as subjective methods. In this study, we investigated team members' shared pupil dilations as a surrogate for surgeon's team performance during a simulated laparoscopic procedure. Fourteen subjects formed dyad teams to perform a simulated laparoscopic object transportation task. Both team members' pupil dilation and eye gaze were tracked simultaneously during the procedure. Video analysis was used to identify key event movement landmarks for subtask segmentation to facilitate data analysis. Three levels of each teams' performance were determined according to task completion time and accuracy (object dropping times). The determined coefficient of determination (R2) was used to calculate the similarity in pupil dilations between 2 individual members' pupil diameters in each team. A mixed-design analysis of variance was conducted to explore how team performance level and task type were correlated to joint pupil dilation. The results showed that pupil dilations of higher performance teams were more synchronized, with significantly higher similarities (R2) in pupil dilation patterns between team members than those of lower performance teams (0.36 ± 0.22 vs. 0.21 ± 0.14, P < 0.001). Levels of pupil dilation synchronization presented among teams reflect differences in performance levels while executing simulated laparoscopic tasks; this demonstrated the potential of using joint pupil dilation as an objective indicator of surgical teamwork performance.

Does the Leaflet Fusion Subtype Affect Pattern and Rate of Growth in BAV Aortopathy?: A Study of 102 BAV Aortopathy Cases With A Literature Review

Bicuspid aortic valves (BAV) and related aortopathy remain an intriguing topic. Not all BAVs get diseased and around 40% would develop aortic dilatation in their lifetime. If haemodynamic theory is to be believed, then leaflet fusion pattern should have an impact. This study sought to compare the association of aortic morphologies and rate of growth in a set of 102 BAV acropathies operated at a single centre, based on the fusion patterns. Data on aortic valve replacements over a 10-year period was analysed from a prospectively maintained database. Of the 198 BAV undergoing surgery, 102 had aortic dilatation above 40 mm on echocardiogram. These underwent computed tomography (CT) aortograms and were followed up as a part of a database. The impact of leaflet fusion patterns on aortic dilatation pattern and rate was analysed. Of the 102, two patients had type 0 pathology and one had left-noncoronary (LN) leaflet fusion. Seventy-four (74) had type 1A or left-right (RL) fusion and 25 had type 1B right-noncoronary (RN) fusion. RL fusion had more males, were taller, bigger and had more proportion of aortic stenosis (AS). Aortic diameters, angles and growth rates at root, ascending/descending aorta and arch were not different. Regression analyses for size or growth did not show any significant impact of fusion pattern. Left-right fusion pattern comprised three-quarters of BAV in this cohort and these patients were bigger, taller and had a greater proportion of males with increased rate of aortic stenosis. Despite these differences, there was no significant impact of fusion pattern on aortic size or rate of growth.

Factors associated with esophageal motility improvement after bilateral lung transplant in patients with an aperistaltic esophagus

ObjectivesWe reported that esophageal peristalsis can improve after lung transplant (LTx), even in patients with pretransplant esophageal aperistalsis. This improvement was associated with better outcomes. We analyzed preoperative factors and sought to predict persistent aperistalsis or motility improvement in patients with pre-LTx esophageal aperistalsis. MethodsPatients with esophageal aperistalsis who underwent LTx between January 2013 and December 2016 were included. Preoperative barium esophagrams were blinded and re-examined; subjective scores were assigned to motility and dilation patterns. Postoperative high-resolution manometry was used to divide patients into 2 groups: persistent esophageal aperistalsis (PEA) or improved esophageal peristalsis (IEP). ResultsWe identified 29 patients: 20 with restrictive lung disease, 7 with obstructive lung disease, and 2 with pulmonary arterial hypertension. Post-LTx, 10 patients had PEA and 19 had IEP (mean age, 53.3 ± 6.6 years and 61.2 ± 10.6 years, respectively; P = .04). All 9 patients (100%) with obstructive lung disease or pulmonary arterial hypertension but only 10 of 20 patients (50%) with restrictive lung disease had IEP post-LTx (P = .01). All 4 patients with scleroderma had PEA. Nearly absent contractility on preoperative esophagrams was more prevalent in the PEA group than in the IEP group (100% vs 58.8%; P = .06). No further differences were observed between the groups. ConclusionsPatients with esophageal aperistalsis and obstructive lung disease or pulmonary arterial hypertension, but not patients with restrictive lung disease and scleroderma, are likely to have IEP post-LTx. Additional studies may determine whether subjective esophagram assessment can help predict IEP post-LTx in patients with restrictive lung disease without scleroderma.

Correlation of Portal and Splenic Vein Diameter with Presence and Size of Esophageal and Gastric Varices in Liver Cirrhosis Patients on MDCT

Introduction: Variceal formation depends upon the pattern of dilatation of the portal and various splanchnic veins in patients with cirrhotic liver and portal hypertension. Multidetector Computed Tomography (MDCT) may be helpful in the evaluation of such gastroesophageal varices and predicting their risk of haemorrhage.Methods: After obtaining ethical clearance and consent, 50 patients meeting the inclusion criteria were included and MDCT obtained. The diameters of the portal vein (PV), splenic vein (SV) and left gastric vein (LGV) were measured and originating vein of LGV determined. Pattern, location and diameter of varix was evaluated. Association between the diameters of the originating vein and the grade and pattern of the esophagael and gastric fundic varices was determined.Results: Of the 50 patients, 41 had gastroesophageal (GE) varices equal to or larger than 1mm with 34% having high-risk varices. The SV was predominantly the originating vein of the LGV. Cutoff SV diameter of 7.75mm and LGV diameter of 5.75mm had a sensitivity of 77.8% with a specificity of 73.2% and 75.6% respectively for the presence of varices.Conclusions: In our study, EV and GEV was more common and mostly supplied by LGV while isolated gastric fundic varices were supplied by non LGV veins only. The diameters of SV and LGV were associated with the presence and grade of esophageal and gastric fundic varices. MDCT is an important non-invasive modality in patients with portal hypertension and should be used for diagnosis, risk stratification and monitoring of varices.

&lt;p&gt;&lt;strong&gt;Two new species of &lt;em&gt;Clinanthus&lt;/em&gt; (Asparagales: Amaryllidaceae: Clinantheae) from northern Peru&lt;/strong&gt;&lt;/p&gt;

Clinanthus fabianae and C. thiagoi are described from Ancash and La Libertad departments of Peru. Both species have similar perigone coloration, broadly lobed staminal coronas, and incurved free filaments. They may represent a distinct species group, along with the previously described C. inflatus. The species can be separated by number of flowers, pedicel length, flower habit, tube length, morphology and pattern of dilation, and color of the tepal apiculum.

Abstract 16534: Pulmonary Artery Tapering Pattern on Chest CT-Angiogram Predicts Phenotype of Pulmonary Hypertension

Introduction: Non-invasive methods to identify phenotype of pulmonary hypertension (PH) are essential to improve the diagnostic algorithm of PH. Hypothesis: Delayed tapering of pulmonary artery (PA) is a signature of pre-capillary PH, while in post-capillary PH, the PA tapers rapidly. This differential tapering pattern of PA can be detected on a chest CT-angiogram (CTA), and quantified as a ratio of main PA diameter to PA branch diameter (right or left) at 5.0 cm length after the PA bifurcation. Methods: We identified 30 subjects with chest CTA and PH confirmed with invasive right heart catheterization (RHC). We identified 3 PH phenotypes: 1. “PVD” (pulmonary vascular disease) = Pre-capillary PH (n=10, PVR&gt;3.0 WU, PAWP &lt;15mmHg), 2. “Mixed” = pre- and post-capillary PH (n=10, PVR&gt;3.0 WU, PAWP &gt;15mmHg), and 3. “PVH” (pulmonary venous hypertension) = post-capillary PH (n=10, PVR&lt;3.0 Woods units [WU], PAWP &gt;15mmHg). Results: The results are summarized in Table. Additional results are expressed as comparison among the three groups in order: PVD vs Mixed vs PVH (mean±SD, % or n, as appropriate). CTA-chest findings: RV basal diameter (mm)= 51.1±8.4 vs 51.0±5.4 vs 38.1±13.9, left ventricular (LV) basal diameter (mm)= 32.1±7.2 vs 31.6±13.3 vs 56.6±15.2*, PA:Ao ratio= 1.1±0.1 vs 1.1±0.2 vs 1.0±0.1. Echo findings: tricuspid annular plane systolic excursion (TAPSE, mm)= 16±3 vs 19±4 vs 22±10*. We performed ROC to identify predictive ability of PA:RPA-5 and PA:LPA-5 to predict PVR&gt;3 WU. The AUC for PA:RPA-5 = 0.859 (p=0.03) and for PA:LPA-5 = 0.812 (p=0.01); with optimal cut-off for both parameters (PA:RPA-5 and PA:LPA-5) was 1.85. Among the overall cohort, the patients with PA:RPA&lt;1.85, 15/16 had PVR&gt;3 and 11/16 were on PH meds. Conclusion: Pattern of PA tapering quantified with PA:RPA-5 or PA:LPA-5 can reliably identify elevated PVR (&gt;3.0 WU). Pre-capillary PH imprints a signature morphological mark on the pattern of PA dilation that can be identified with a CTA-thorax.

Slower Speaking Rate Reduces Listening Effort Among Listeners With Cochlear Implants.

Slowed speaking rate was examined for its effects on speech intelligibility, its interaction with the benefit of contextual cues, and the impact of these factors on listening effort in adults with cochlear implants. Participants (n = 21 cochlear implant users) heard high- and low-context sentences that were played at the original speaking rate, as well as a slowed (1.4× duration) speaking rate, using uniform pitch-synchronous time warping. In addition to intelligibility measures, changes in pupil dilation were measured as a time-varying index of processing load or listening effort. Slope of pupil size recovery to baseline after the sentence was used as an index of resolution of perceptual ambiguity. Speech intelligibility was better for high-context compared to low-context sentences and slightly better for slower compared to original-rate speech. Speech rate did not affect magnitude and latency of peak pupil dilation relative to sentence offset. However, baseline pupil size recovered more substantially for slower-rate sentences, suggesting easier processing in the moment after the sentence was over. The effect of slowing speech rate was comparable to changing a sentence from low context to high context. The effect of context on pupil dilation was not observed until after the sentence was over, and one of two analyses suggested that context had greater beneficial effects on listening effort when the speaking rate was slower. These patterns maintained even at perfect sentence intelligibility, suggesting that correct speech repetition does not guarantee efficient or effortless processing. With slower speaking rates, there was less variability in pupil dilation slopes following the sentence, implying mitigation of some of the difficulties shown by individual listeners who would otherwise demonstrate prolonged effort after a sentence is heard. Slowed speaking rate provides release from listening effort when hearing an utterance, particularly relieving effort that would have lingered after a sentence is over. Context arguably provides even more release from listening effort when speaking rate is slower. The pattern of prolonged pupil dilation for faster speech is consistent with increased need to mentally correct errors, although that exact interpretation cannot be verified with intelligibility data alone or with pupil data alone. A pattern of needing to dwell on a sentence to disambiguate misperceptions likely contributes to difficulty in running conversation where there are few opportunities to pause and resolve recently heard utterances.

Coarse-to-fine waterlogging probability assessment based on remote sensing image and social media data

ABSTRACT Urban waterlogging probability assessment is critical to emergency response and policymaking. Remote Sensing (RS) is a rich and reliable data source for waterlogging monitoring and evaluation through water body extraction derived from the pre- and post-disaster RS images. However, RS images are usually limited to the revisit cycle and cloud cover. To solve this issue, social media data have been considered as another data source which are immune to the weather such as clouds and can reflect the real-time public response for disaster, which leads itself a compensation for RS images. In this paper, we propose a coarse-to-fine waterlogging probability assessment framework based on multisource data including real-time social media data, near real-time RS image and historical geographic information, in which a coarse waterlogging probability map is refined by using the real-time information extracted from social media data to acquire a more accurate waterlogging probability. Firstly, to generate a coarse waterlogging probability map, the historical inundated areas are derived from Digital Elevation Model (DEM) and historical waterlogging points, then the geographic features are extracted from DEM and RS image, which will be input to a Random Forest (RF) classifier to estimate the likelihood of hazards. Secondly, the real-time waterlogging-related information is extracted from social media data, where the Convolutional Neural Network (CNN) model is applied to exploit the semantic information of sentences by capturing the local and position-invariant features using convolution kernel. Finally, fine waterlogging probability map scan be generated based on morphological method, in which real-time waterlogging-related social media data are taken as isolated highlight point and used to refine the coarse waterlogging probability map by a gray dilation pattern considering the distance-decay effect. The 2016 Wuhan waterlogging and 2018 Chengdu waterlogging are taken as case studies to demonstrate the effectiveness of the proposed framework. It can be concluded from the results that by integrating RS image and social media data, more accurate waterlogging probability maps can be generated, which can be further applied for inundated areas identification and disaster monitoring.

Short-term effects of maximal dynamic exercise on flow-mediated dilation in professional female soccer players.

Endothelial function assessment may provide important insights into the cardiovascular function and long-term effects of exercise training. Many studies have investigated the possible negative effects on cardiovascular function due to extreme athletic performance, leading to undesirable effects. The purposes of this study were to investigate the acute effects of maximal intensity exercise on endothelium-dependent vasodilation, and to understand the patterns of flow-mediated dilation (FMD) change following maximal exercise in elite female athletes with a high-volume training history. Twenty-six elite female soccer players (mean age, 22±4 years; BMI, 21±2 kg/m2; VO<inf>2max</inf>, 41±4 mL/kg/min) were evaluated. Brachial artery FMD was determined using high-resolution ultrasound at rest, and after 15 and 60 min of maximal cardiopulmonary exercise (CPX) testing on a treadmill. Flow velocity was measured at baseline and during reactive hyperemia at the same periods. Rest FMD was 12.4±5.5%. Peak diameter in response to reactive hyperemia was augmented after 15 min of CPX (3.5±0.4 vs. 3.6±0.4 mm, P<0.05), returning to resting values after 60 min. However, %FMD did not change among time periods. There were two characteristic patterns of FMD response following CPX. Compared to FMD at rest, half of the subjects responded with an increased FMD following maximum exercise (10.5±6.1 vs. 17.8±7.5%, P<0.05). The other subjects demonstrated a reduced FMD response following maximum exercise (14.2±4.3 vs. 10.9±3.2%, P<0.01). These results indicate that elite female soccer players presented robust brachial artery FMD at rest, with a heterogeneous FMD response to acute exercise with a 50% FMD improvement rate.

Spatial and temporal patterns of nitric oxide diffusion and degradation drive emergent cerebrovascular dynamics.

Nitric oxide (NO) is a gaseous signaling molecule that plays an important role in neurovascular coupling. NO produced by neurons diffuses into the smooth muscle surrounding cerebral arterioles, driving vasodilation. However, the rate of NO degradation in hemoglobin is orders of magnitude higher than in brain tissue, though how this might impact NO signaling dynamics is not completely understood. We used simulations to investigate how the spatial and temporal patterns of NO generation and degradation impacted dilation of a penetrating arteriole in cortex. We found that the spatial location of NO production and the size of the vessel both played an important role in determining its responsiveness to NO. The much higher rate of NO degradation and scavenging of NO in the blood relative to the tissue drove emergent vascular dynamics. Large vasodilation events could be followed by post-stimulus constrictions driven by the increased degradation of NO by the blood, and vasomotion-like 0.1–0.3 Hz oscillations could also be generated. We found that these dynamics could be enhanced by elevation of free hemoglobin in the plasma, which occurs in diseases such as malaria and sickle cell anemia, or following blood transfusions. Finally, we show that changes in blood flow during hypoxia or hyperoxia could be explained by altered NO degradation in the parenchyma. Our simulations suggest that many common vascular dynamics may be emergent phenomena generated by NO degradation by the blood or parenchyma.

Isolated Endomyocardial Fibrosis of the Right Ventricle

We describe a case of tropical right ventricular (RV) endomyocardial fibrosis. By CMR, a typical pattern of RV dilatation with apical obliteration was found, and late gadolinium enhancement of the obliterated part was present, confirming fibrosis. By T1-mapping, myocardial extracellular volume was elevated suggesting associated intramyocardial interstitial fibrosis and highlighting the importance of tissue characterisation to diagnose this condition.

Relationship Between Eye-Movement Patterns, Cognitive Load, and Reading Ability in Children with Reading Difficulties.

Children with reading difficulties (RD) share challenges in executive functions (EF). Neurobiological correlates provide evidence for EF challenges during reading among these readers, but an online cognitive load detection mechanism has yet to be developed. Nevertheless, eye-movement tracking can provide online data of reading patterns (pupil dilation, fixations) and, indeed, atypical eye-movement patterns of children with RD during reading have been documented. To identify eye-movement patterns related to increased cognitive load during reading in children with RD compared to typical readers, eye movements of 8-12-year-old English-speaking children were recorded during their reading of sentences with increasing difficulty (sentences that make sense, then sentences that do not make sense) and comparing incorrect and correct responses. Children with RD demonstrated greater pupil dilation when reading sentences that make sense than when reading sentences that do not make sense and also when reading incorrectly, compared to typical readers. Increased pupil dilation in children with RD when reading sentences correctly was positively correlated with phonological awareness capabilities. Higher phonological awareness and reading abilities were related to increased pupil dilation only in children with RD during correct reading, which is related to a heavier cognitive load. Results suggest that in addition to traditional findings of altered fixation patterns in children with RD, increased pupil dilation during reading may reflect EF challenges among this population. These findings can potentially be used to adapt online written materials for children with RD based on their fixation and pupil dilation patterns.

Statistical Shape Analysis of Ascending Thoracic Aortic Aneurysm: Correlation between Shape and Biomechanical Descriptors.

An ascending thoracic aortic aneurysm (ATAA) is a heterogeneous disease showing different patterns of aortic dilatation and valve morphologies, each with distinct clinical course. This study aimed to explore the aortic morphology and the associations between shape and function in a population of ATAA, while further assessing novel risk models of aortic surgery not based on aortic size. Shape variability of n = 106 patients with ATAA and different valve morphologies (i.e., bicuspid versus tricuspid aortic valve) was estimated by statistical shape analysis (SSA) to compute a mean aortic shape and its deformation. Once the computational atlas was built, principal component analysis (PCA) allowed to reduce the complex ATAA anatomy to a few shape modes, which were correlated to shear stress and aortic strain, as determined by computational analysis. Findings demonstrated that shape modes are associated to specific morphological features of aneurysmal aorta as the vessel tortuosity and local bulging of the ATAA. A predictive model, built with principal shape modes of the ATAA wall, achieved better performance in stratifying surgically operated ATAAs versus monitored ATAAs, with respect to a baseline model using the maximum aortic diameter. Using current imaging resources, this study demonstrated the potential of SSA to investigate the association between shape and function in ATAAs, with the goal of developing a personalized approach for the treatment of the severity of aneurysmal aorta.

Progression of the first stage of spontaneous labour.

This chapter reviews and compiles the most recent published evidence assessing the overall labour duration and patterns of progression for both nulliparous and parous women, as well as the accuracy of the alert and action lines in the World Health Organization (WHO) partograph for the identification of women at risk of birth complications. Systematic reviews of observational studies reporting on the duration of the first and the second stages of labour, and on cervical dilatation patterns for women with low risk of complications with 'normal' perinatal outcomes were identified and updated. The accuracy of the alert (1cm/h) and action lines of the cervicograph in the partogram to predict adverse birth outcomes among women in first stage of labour was also reviewed, questioning the appropriateness of considering cervical dilatation over time as an isolated indicator to define labour progression or arrest.

How mandibular advancement splints alter genioglossus airway dilation patterns during inspiration in awake people with obstructive sleep apnoea may help predict treatment outcomes

How mandibular advancement splints alter genioglossus airway dilation patterns during inspiration in awake people with obstructive sleep apnoea may help predict treatment outcomes

P5564The myocarditis as a regular phenomenon in primary noncompact myocardium: clinical and morphological diagnostics, significance and treatment

Abstract Purpose To estimate the frequency of myocarditis in adult patients with noncompact myocardium (NCM) of the left ventricle (LV), its influence on the disease, the outcome and results of treatment. Methods We included 103 adult patients with NCM (61 males, 45.6±14.9 years). The average EDD LV was 6.0±0.8 cm, LV EF 38.8±14.5%. To diagnose NCM were performed Echo-CG, CT (n=81) and MRI (n=39). We performed NGS sequencing, followed by Sanger sequencing of detected variants (revealed in 9% of patients in the genes MYH7, MyBPC3, LAMP2, DES, DSP, TTN). The examination also included anti-heart antibodies and viruses (PCR) study and morphological study in 19 patients (endomyocardial biopsy in 14, intraoperative biopsy in 1, explanted heart study in 1 and autopsy in 3). The mean follow-up was 12 [2; 32] months. Results The myocarditis was diagnosed in 55 (53.4%) patients with NCM: in 19 patients by morphological study (active in 10 and borderline in 9 patients) and in 36 patients on the basis of a complex examination (the relationship with a respiratory infection, a 3–4-fold increase in the anti-heart antibodies, the viral genome in the blood, pericardial effusion, subepicardial LGE). The myocarditis was virus-positive in 17 patients (36.1%). The parvovirus B19, human herpes virus type 6, cytomegalovirus, herpes simplex virus and Epstein-Barr virus were detected in the myocardium in 8 patients (42.1%), and in 14 patients (25.5%) in the blood. Pathogenic genetic variants were revealed in four patients with morphologically verified myocarditis. The rate of myocarditis depended on the clinical form of NCM: 44.4% in arrhythmic form, 12.5% in chronic ischemic form, 57.5% in dilated pattern and 50.0% in association of NCM with other cardiomyopathies. In 10% of all patients, acute myocarditis was the first manifestation of the disease. In 5% the myocardial necrosis was the main manifestation of the myocarditis. The association of NCM with myocarditis led to more severe myocardial dysfunction (NYHA class 2 [1; 3] v 1.75 [0; 2], p&lt;0.01, EF 33.8±13.5 v 44.7±13.6%, p&lt;0.001), higher rate of the nonsustained ventricular tachycardia (67.3% v 29.3%, p&lt;0.01), appropriate shocks of defibrillators (38.9% v 0, p&lt;0.05), death (16.4 and 4.2%, OR 5.75, 95% CI 1.21–27.43, p&lt;0.05), and heart transplantation (7.3% v 2.1%, p&gt;0.05). Only in patients with myocarditis, there was a significant increase in EF (in acute myocarditis from 25.4±7.9 to 38.6±9.5%, p&lt;0.01), decrease sizes of the LV and systolic pulmonary artery pressure as a result of basic therapy. Morphological verification of myocarditis Conclusion Myocarditis is a regular phenomenon that develops in half of patients with primary NCM. The nature of myocarditis in NCM may be different (primary infectious and immune, secondary in response to genetic/ischemic damage to cardiomyocytes). However, it leads to a significant deterioration of structural and functional parameters, an increase in life-threatening arrhythmias, unfavorable outcomes and requires basic therapy.

P3734Feasibility of percutaneous pulmonary valve implantation in the native right ventricle outflow tract from in vivo dynamic regional strain analysis

Abstract Background Patients surgically treated for congenital heart disease (e.g., Tetralogy of Fallot) frequently report long-term dysfunctions (i.e., pulmonary stenosis and/or incompetence) of the native right ventricle outflow tract (RVOT). The efficacy of percutaneous pulmonary valve implantation (PPVI) is recognized worldwide; however, the procedure is only feasible in RVOTs with appropriate size and functional substrate. Accordingly, a three-dimensional (3D) and dynamic assessment of the native RVOT function can be crucial to identify patients who can effectively benefit from PPVI, thus avoiding the risk of device embolization or fracture. Purpose We herein exploited an optical flow-based approach to develop a novel 3D framework for the quantitative in vivo assessment of dimension and dynamic changes of the native RVOT throughout the cardiac cycle. PPVI candidates (n=15) with previous surgery of the native RVOT were enrolled to demonstrate the additional contribution of our 3D patient-tailored analysis to the decision-making process. Methods Contrast-enhanced computed tomography (CT) was performed on a 64-slice dual-source multidetector CT system with retrospective ECG-gating. Multi-phase images of the RVOT were acquired at each 10% increment of the cardiac cycle (slice thickness = 1.5mm, increment = 1mm, pixel spacing = 0.35mm). We implemented a dedicated in-house framework, based on the optical flow tracking algorithm, to dynamically follow three anatomical cross-sections (i.e., proximal, mid and distal) of the native RVOT. The time course of area, perimeter and other relevant parameters (e.g., equivalent radius, elliptical ratio) were extracted and both areal (εA) and longitudinal strain (εlong) were computed on each the RVOT tracked cross-section. Maximum regional strain were calculated between the maximum and minimum value over the cardiac cycle. Dynamic changes in CT-derived variables were assessed using analysis of variance (p&lt;0.05, statistically significant). Results All the enrolled anatomies were successfully analysed, locally pinpointing the in vivo pattern of deformation within each 3D RVOT anatomy (a). Anatomical regional RVOT dimensions (p&lt;0.0001) and changes proved to be significantly different (p≤0.0002) throughout the cardiac cycle. In addition, the dysfunctional RVOT anatomy exhibited an irregular pattern of contraction and dilation: maximum regional strains markedly differed between RVOT regions, e.g., comparing the εA between RVOT mid (22.6%) and distal (46.0%) regions. In vivo tracking of RVOT dynamic changes Conclusions The combination of patient-specific in vivo imaging and bioengineering strategies can improve our understanding of RVOT dysfunctions in congenital patients referred to PPVI. Our optical flow-based and clinically-oriented framework can support the patient selection process and the planning of the percutaneous procedure in order to enhance its efficacy and shorten the operating time while improving the patient safety. Acknowledgement/Funding IRCCS Policlinico San Donato is a clinical research hospital partially funded by the Italian Ministry of Health

Altered inspiratory airway dilation patterns with mandibular advancement splints may help predict treatment outcomes

Altered inspiratory airway dilation patterns with mandibular advancement splints may help predict treatment outcomes